Healthcare Provider Details

I. General information

NPI: 1134378359
Provider Name (Legal Business Name): ONE WAY OUT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2008
Last Update Date: 09/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 OXMOOR RD
HOMEWOOD AL
35209-5317
US

IV. Provider business mailing address

1021 OXMOOR RD
HOMEWOOD AL
35209-5317
US

V. Phone/Fax

Practice location:
  • Phone: 205-870-3911
  • Fax: 205-879-3911
Mailing address:
  • Phone: 205-870-3911
  • Fax: 205-879-3911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number2020
License Number StateAL

VIII. Authorized Official

Name: TAYLOR FLANNAGAN
Title or Position: OWNER
Credential: DC
Phone: 205-870-3911